The things that have helped me the most in the midst of severe panic attacks have not been attempts to "cure" the attacks, but to reframe the narrative of what I'm experiencing.

If you google "panic attack cure," you get more than 1.5 million results. There are breathing techniques, herbal cures, and benzos. There are specialists, online courses, and worry stones. As someone who has lived with panic disorder for 17 years (and anxiety disorder for a lifetime), I've tried a lot of what's for sale in the anti-anxiety marketplace. I've been in therapy for decades. I've meditated for a decade and done hypnosis. I've read the books, watched the instructional videos, and engaged in the online courses. I've received acupuncture and herbs. I've gone to a shaman, bought the crystals, and said the affirmations. I've been addicted to alcohol. I've gotten deep into benzos and opiates. Before I got clean and sober, I frequently experimented with acid, peyote, psilocybin, and MDMA. Weed was my best friend—then my paranoiac enemy.

I'd say that of all the things I've spent money on in relation to my anxiety disorder, the most effective treatment for me has been the juxtaposition of a form of cognitive behavioral therapy called ACT and finding the right combination of psychotropic medication with my psychiatrist (which sometimes needs to be adjusted). But neither of these things alone have put an end to my panic attacks, or the heightened general anxiety I've lived with since I was a little kid. In fact, it's often been in looking for a "cure" that I've triggered myself into a deeper relapse of panic attacks.

Each time I come to new modalities, it's always with a sense of desperation. I spend the money, cross my fingers, and pray that the thing will "work." But I am on such high alert that the moment I feel a strange sensation in my body—whether it be a sniffle or lightheadedness—my catastrophic mind says, Oh no. For me, oh no is usually followed by I'm dying, at which point the physical symptoms of a panic attack kick in: suffocating sensations, rapid heartbeat, tingling in my arms and legs, surges of adrenaline, nausea (a fairly new one!), flashes of heat (also new), dissociation (an oldie but scary). When this happens in the midst of a treatment that I'd hoped would be the cure, I can feel hopeless, like nothing is ever going to work.

Alternately, the modalities that have helped me the most when I've been in a relapse of severe panic attacks have not been attempts to "cure" the attacks, but rather, to reframe the narrative of what I'm experiencing. It is the times when I've found ways—sometimes creative, sometimes cognitive behavioral-therapy oriented—to observe, work with, and even actively engage in my panic attacks that have helped me get back on safer and more peaceful shores psychologically.

Anxiety disorders are smart. Often, they are conditions found in very imaginative people. Therefore, as the imagination shape shifts, the focus of one's anxiety can shapeshift—from the most free-floating existential dread to a new, very tangible symptom of one's imminent death to an obsession with one of life's more mundane details. Thus, I've never been able to rely on one solution alone when a relapse rears its head.

There are three different periods of my life in particular, when nothing else seemed to be working, in which I only found psychological shelter by surrendering to—rather than attempting to permanently eradicate—my anxiety. Each time was different, but the commonality was a willingness to say, OK, fuck it. I'm going to work with you.

A panic attack can be seen as an opportunity to practice a new set of tools, rather than something terrible that is just happening to me.

The first time was when I discovered the Panic Away ebook online. Panic Away has now developed into a whole system, but at the time I found the ebook, it was literally just a Microsoft Word document that you could download online, featuring a picture of its author skydiving on the first page. That ebook was one of the few things for purchase that I ever recommend to anyone with panic disorder—not because it was an instant cure—but because the author, Barry McDonagh, introduced me to a new way of thinking about my panic attacks. He presented the idea that I can be an active participant in the experience: that a panic attack can be seen as an opportunity to practice a new set of tools, rather than something terrible that is just happening to me. He also explored the idea that a person with panic disorder will suffer less if they are able to find meaning in the experience, in part by helping others, as explored by psychologist and Auschwitz survivor Viktor Frankl.

Viktor Frankl. Illustration by Joel Benjamin

The second time I was able to create an alternate narrative around a relapse of panic attacks was when I started the @sosadtoday Twitter account. At the time, I was in a very desperate place, experiencing the worst cycle of panic attacks and depression I ever had. All of the things I'd found effective in the past: my meds, the ebook, psychodynamic therapy, were not working. I was afraid that I was not going to be able to keep my job, which involved sitting at a desk day after day, because I was literally vibrating with terror. So in a small, dark corner of the internet, I created the account—anonymously—and started channeling everything I was feeling into that portal. Many years later, I'm still tweeting, so clearly this was not a panacea: the thing that would render me at peace forever. But the account has given me what one might call an alternate use for my own suffering. What began solely as an emergency pressure valve has connected me with so many others over the years. In sharing my experience honestly (and anonymously at first for three years), I've discovered that I'm not alone and have helped others know they aren't alone either.

The most recent modality that has helped me with my anxiety disorder are ACT/CBT techniques, mostly written ones. While I can't afford to go to the amazing therapist I was seeing for about nine months after I reached a crisis point (she doesn't take my insurance), I've found a site with amazing free anxiety CBT resources for continuing to do the written work. My favorite is this panic diary, and I also like this health anxiety worksheet. By keeping a panic diary, I can feel like more of an active participant in the experience—and that I am, if not in control, at least involved in the narrative. I am given a context and a framework in a psychological space that can feel like there is no floor or ceiling.

There are people who say they have stopped their panic attacks forever. That's awesome. For me, I think that to permanently eradicate my anxiety disorder would entail finding a cure for life, a cure for death, a cure for living in the world—some way to bandage the existential questions that, for me, have always come with existence. I have tried shutting down those questions, but they always resurface in more terrifying ways. People say, "You are not your anxiety," and I get that. But perhaps the disorder is not so much a disorder at all as a heightened sensitivity to being alive.

Buy So Sad Today: Personal Essays on Amazon, and follow her on Twitter.